NEW YORK, Aug. 16, 2012 /PRNewswire/ -- A patient, a surgeon, and a robot walk into the operating room – but it's no joke. With prostate cancer as the punch line, preserving erectile function and enjoying sex after prostatectomy surgery is no laughing matter. Many men with prostate cancer are eager to get it out, but potential trade-offs are a big concern. How can I be sure my sex life will live as long as I do? In truth, prostate cancer treatment and recovery is highly individual, but one surgeon is setting the bar pretty high.
Mount Sinai Medical Center's robotic prostatectomy surgeon, Dr. David Samadi, explains how he and his robot are optimizing quality of life for men after prostate cancer. "We shoot for three success factors – prostate cancer cure, sexual potency, and urinary continence," said Dr. Samadi. "To get there we need three critical components – the right patient with localized prostate cancer, a superior robotic surgery technique, and patient commitment to recovery."
For a man who spends nearly every day next to a robot, Dr. Samadi gives credit where credit is due; his electronic co-worker is just another member of his dedicated surgical team. Here's his take on making room for the robot:
"Robotics are an important part of my evolving surgical career, but I didn't just jump from traditional and laparoscopic surgery to the robot. There's a seasoned transition behind the way I operate. I found a way to improve outcomes by combing proficiencies in all three surgical principal," he said.
Those surgical outcomes speak loud and clear. In Dr. Samadi's care, and with proper compliance to post-surgery follow-up, 96 percent of patients regain urinary control in 2-3 months and 85 percent are sexually potent 12-24 months after surgery.
But how exactly does he do it? While some might think it's as simple as saddling up to the highly regarded da Vinci robot, Dr. Samadi says that's far from the answer.
"If my only responsibility was to remove the cancerous prostate, my job would be much easier," he acknowledges, "But patients deserve much more than that. It was paramount that I find a way to remove the prostate gland without damaging functions critical to a comfortable and enjoyable life after recovery."
SMART Surgery Explained
In essence, Dr. Samadi's SMART (Samadi Modified Advanced Robotic Technique) robotic prostatectomy surgery accomplishes more by doing less.
Unlike traditional prostate removal surgery that approaches the prostate from the outside in, SMART surgery accesses the prostate from the inside out. Without cutting or damaging three critical areas – the endo pelvic fascia, the neurovascular bundles, and the urinary sphincter – Dr. Samadi optimizes post-surgery sexual function and urinary continence.
Further, the dorsal vein complex is left unstitched until the end of the procedure, allowing Dr. Samadi to control the length of the urethra and minimize leaking after surgery. He uses only cold scissors and clips, never highly nerve-damaging cautery, and every surgery from open to close is completely in his hands.
Of course, the robot enhances each of these steps. Improved visibility, less blood loss, and greater dexterity all come from the precision of robotics. But as much as we love technology, patients still want to know: What happens if the robot breaks?
That's where Dr. Samadi's 3-in-1 expertise comes full circle. He cautions, "Robotic surgeons are becoming more widely available, but patients need to ask hard-hitting questions. Is your robotic surgeon experienced in traditional oncologic surgery or are they simply a newly-trained robotic technician?"
The answer for Dr. Samadi is perfectly clear to the more than 4,000 men and families for whom he's helped make prostate cancer a distant memory.
Dr. Samadi leaves men with these encouragements, "Choose treatment wisely, but choose your surgeon even more wisely. And don't hesitate to take advantage of ED tools such as oral medication or penile injections after surgery. You may only need them for a short time, but they'll get you back on track faster. Patients have to play an active role in their recovery from diagnosis to a happy, healthy life after surgery."